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Student Health Insurance Options at Ball State

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Nefouse & Associates, Inc. is a health insurance agency that provides Ball State University students and their parents with information on all available health insurance options.

Our goal is to educate families and students on the choices in today’s individual market and help them understand what coverage works best for their situation, because every situation can be unique.

Ball State does not currently offer a student health insurance plan for domestic students. This change came after the Affordable Care Act allowed parents to keep children on their health plans until age 26. As a result, enrollment in traditional student health plans declined, and Ball State—like many other universities—no longer had enough participation to continue offering the program.

Health Insurance Options

Ball State students and their families typically need to choose a single health insurance policy outside of the university. The best policy will depend on the student’s needs and budget, and every situation can be unique.

Marketplace Coverage (ACA Plans)

Marketplace plans are available through the federal exchange and must meet Affordable Care Act requirements.

  1. These plans cover pre-existing conditions and include essential benefits like preventive care, prescriptions, hospital care, and emergency services.
  2. In Delaware County and across Indiana, the main carriers are Ambetter, Caresource, and Anthem.
  3. Costs are based on age, carrier, and plan design.
  4. Many students may qualify for premium assistance (subsidies). This is financial help from the federal government that lowers the monthly cost of health insurance. To be eligible, students must meet certain income requirements, file their own tax return, and cannot be claimed as a dependent on a parent’s taxes.

Marketplace coverage is usually the most comprehensive option for students who don’t have access to an employer or parent’s plan.

FeatureMarketplace Plans (ACA)Off-Exchange PlansShort-Term Plans
Covers pre-existing conditions✅ Yes✅ Yes❌ No
Essential health benefits (hospital, prescriptions, preventive, etc.)✅ Yes✅ Yes❌ Limited
Subsidies / Premium Assistance✅ Available if eligible❌ Not available❌ Not available
Provider NetworksUsually HMO (limited networks)May include PPO (broader networks)Limited
Enrollment ProcessThrough federal marketplaceDirect with carrier
Best ForStudents who qualify for subsidies or need full coverageIndividuals who don’t qualify for subsidies and want more plan choiceStudents needing short-term, temporary coverage
CostsBased on age, carrier, and plan design (with subsidies applied if eligible)Based on age, carrier, and plan designUsually lower premiums but less coverage

Off-Exchange Health Coverage

Off-exchange health coverage refers to ACA-compliant plans purchased directly from the insurance carrier instead of through the federal marketplace. These plans follow the same rules and include the same essential health benefits as marketplace plans.

  1. Off-exchange plans are not tied to federal subsidies, so students pay the full premium without government assistance.
  2. Some individuals prefer this option if they do not qualify for premium assistance or want a broader range of plan designs.
  3. In some cases, PPO options may be available, which can provide a larger network of doctors and hospitals compared to many marketplace HMO plans.
  4. The enrollment process is handled outside of the marketplace, which can be much smoother and more direct.
  5. In Indiana, carriers such as Anthem often offer both marketplace and off-exchange policies.
  6. Costs are based on age, carrier, and plan design.

Off-exchange coverage may be a good option for individuals who want flexibility in plan selection, a broader provider network, and a simpler enrollment process.

Short-Term Health Insurance

Off-exchange health coverage refers to ACA-compliant plans purchased directly from the insurance carrier instead of through the federal marketplace. These plans follow the same rules and include the same essential health benefits as marketplace plans.

  1. Off-exchange plans are not tied to federal subsidies, so students pay the full premium without government assistance.
  2. Some individuals prefer this option if they do not qualify for premium assistance or want a broader range of plan designs.
  3. In some cases, PPO options may be available, which can provide a larger network of doctors and hospitals compared to many marketplace HMO plans.
  4. The enrollment process is handled outside of the marketplace, which can be much smoother and more direct.
  5. In Indiana, carriers such as Anthem often offer both marketplace and off-exchange policies.
  6. Costs are based on age, carrier, and plan design.

Off-exchange coverage may be a good option for individuals who want flexibility in plan selection, a broader provider network, and a simpler enrollment process.

Frequently Asked Questions
General Questions
Q: Does Ball State require students to have health insurance

A: No, but having coverage protects you from high medical costs if you need care.

Q: Can I stay on my parent's health insurance plan?

A: Yes. Students can stay on a parent’s plan until age 26. However, you’ll want to check if the plan’s provider network includes doctors and hospitals near Muncie.

Q: What happens if I don't have health insurance?

A: There’s no tax penalty anymore, but medical bills can be extremely expensive without coverage. Even one ER visit can cost thousands of dollars.

Marketplace Coverage
Q: What is premium assistance (subsidies)?

A: Premium assistance is financial help from the federal government that lowers your monthly cost. To qualify, you must meet income requirements, file your own tax return, and not be claimed as a dependent on your parent’s taxes.

Q: Are marketplace plans good for students?

A: Yes, especially if you qualify for subsidies. They provide comprehensive coverage and include all essential health benefits.

Q: When can I enroll in a marketplace plan?

A: Marketplace enrollment is typically open from November 1 through January 15 each year. Outside of this period, you can only enroll if you experience a Qualifying Life Event (QLE) — such as losing other coverage, turning 26, moving to a new area, or a change in household (like marriage).

Q: I am losing my employer-sponsored plan that covers my student. What are my options?

A: Losing employer coverage is a Qualifying Life Event (QLE). You typically have two paths:

  1. Elect COBRA through your employer, which allows you to continue the same plan for a limited time (usually up to 18 months) but at full cost.
  2. Enroll in a Marketplace or Off-Exchange plan, where your student can choose a new individual policy. If your student qualifies for subsidies, marketplace coverage may be more affordable than COBRA.
Off-Exchange Coverage
Q: Why would someone choose an off-exchange plan?

A: Off-exchange plans are ACA-compliant but purchased directly from the insurance company instead of through the marketplace. They’re a good fit for students or individuals who don’t qualify for subsidies and want more plan design options.

Q: Do off-exchange plans have better networks?

A: Sometimes. Off-exchange plans may include PPO networks, which give you more freedom to see doctors and hospitals without needing referrals.

Q: Is the enrollment process easier?

A: Yes. Since you enroll directly with the carrier, the process is often smoother and quicker than going through the federal marketplace.

Q: When can I enroll in an off-exchange plan?

A: Off-exchange plans generally follow the same rules as marketplace plans. That means you can enroll during open enrollment or after a Qualifying Life Event (QLE), such as losing coverage, turning 26, or moving to a new ZIP code.

Short-Term Coverage
Q: When does a short-term plan make sense?

A: Short-term plans are best for students who need temporary coverage — for example, during a gap between other policies.

Q: What doesn't short-term insurance cover?

A: They do not cover pre-existing conditions and often exclude services like prescriptions, maternity care, and mental health treatment.

Q: Is short-term insurance a long-term solution?

A: No. It’s designed to be temporary and should not replace full health coverage

For Parents
Q: My child is attending Ball State but we live out-of-state. Will our insurance still work?

A: It depends. Many employer-based plans cover nationwide, but some HMO or regional plans may not. Check your network before your student leaves for school.

Q: What happens when my student turns 26?

A: At that point, they can no longer stay on a parent’s plan and must get their own coverage through the marketplace, off-exchange, or employer coverage.

Q: Is it cheaper to put my child on an individual plan instead of my employer plan?

A: Maybe. Most employer plans use tiered rates, which means the cost is the same whether you cover a married couple with one child or seven children. If you are still covering additional children along with your Ball State student, it is usually better to keep them on the employer plan. However, if your Ball State student is the last child covered under your plan, it may be more cost-effective to move them to an individual policy.

Q: We reside in another state and currently have coverage through the marketplace. Should we purchase a separate policy for our student?

A: Maybe. If you are currently receiving tax credits (premium assistance) through the marketplace, it may be more cost-effective to keep that coverage in place. Before making changes, check the provider network in Indiana to make sure your student will have access to local doctors and hospitals.

Q: We currently have a plan that is on an HMO network. Will my student have coverage at Ball State?

A: Yes, your student will be covered for emergency room care, because all ACA-compliant plans must treat emergencies as in-network. However, for routine care (like office visits or ongoing treatment), your student may have to pay out-of-pocket if the provider is outside the HMO network. In this situation, families often review whether an individual policy or a PPO option might provide better access to care.

For Students
Q: I only go to the doctor once a year. Do I really need health insurance?

A: Yes. Even one ER visit can cost thousands of dollars. Health insurance protects you from unexpected medical bills and gives you access to preventive care and prescriptions.

Q: Can I get dental or vision coverage too?

A: Yes, but those are usually separate add-ons. Marketplace and off-exchange plans often allow you to include dental or vision coverage for an additional premium.

Q: What if I move back home for the summer?

A: Your coverage typically moves with you, but always check your provider network to make sure your doctors are included in both locations.

Q: What's the difference between an HMO and a PPO plan?

A: An HMO (Health Maintenance Organization) plan usually has a smaller network of doctors and hospitals. You’ll need to stay in that network for most care, and out-of-network care isn’t covered except for emergencies.

Q: We currently have a plan that is on an HMO network. Will my student have coverage at Ball State?

A: Yes, your student will be covered for emergency room care, because all ACA-compliant plans must treat emergencies as in-network. However, for routine care (like office visits or ongoing treatment), your student may have to pay out-of-pocket if the provider is outside the HMO network. In this situation, families often review whether an individual policy or a PPO option might provide better access to care.

A PPO (Preferred Provider Organization) plan generally has a larger network and lets you see doctors both in and out of the network, though out-of-network care costs more.

For students, the main difference comes down to flexibility and where you plan to receive care.

How We Can Help

At Nefouse & Associates, we help Ball State students and parents navigate every available health insurance option — whether that’s a Marketplace plan, Off-Exchange policy, or Short-Term coverage. Our goal is to simplify the process and make sure you understand your choices before you enroll.

Contact us today to review your student health insurance options and find the best fit for your situation.

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